Prolactin May Be Increased in Newly Diagnosed Celiac Children and Adolescents and Decreases after 6 Months of Gluten-Free Diet

Abstract

Background/Aims: Prolactin (PRL) is produced by the anterior pituitary gland. It exerts its role on the breast gland but also plays a modulatory role in autoimmune mechanisms. Celiac disease (CD) is a gluten-sensitive autoimmune enteropathy sometimes associated with autoimmune endocrinopathies. No data on PRL levels in CD patients are available at diagnosis, and no conclusive data are reported. Methods: We aimed to evaluate PRL secretion in newly diagnosed CD pediatric patients and, in the case of hyperprolactinemia, any changes in its levels while the patients were on a gluten-free diet (GFD). We recruited 67 patients and 39 healthy controls. Results: PRL was statistically higher in the CD patients (13.5 ± 9.2 ng/ml) than in the controls (8.5 ± 5.0 ng/ml). In the CD group, PRL was inversely correlated with the age at diagnosis (r = -0.326; p = 0.007). In patients with hyperprolactinemia at diagnosis, PRL decreased after 6 months of GFD. Conclusion: This paper confirms that PRL may be increased at diagnosis of CD and shows, for the first time, that it decreases after a short course of GFD. Changes in the levels of inflammatory cytokines in CD may account for changes in PRL levels. Younger patients seem more prone to develop hyperprolactinemia than older ones.

Increased Expression of TLR4 and TLR7 but Not Prolactin mRNA by Peripheral Blood Monocytes in Active Celiac Disease

“…Significantly higher serum PRL levels in CD patients than in controls, with a reduction after six months of a GFD [30], and serum hyperprolactinemia in patients with active disease but not in treated CD subjects [24,31] point to the direct involvement of PRL in the pathogenesis of CD. This is supported by the fact that it has been shown that elevated serum PRL levels in CD patients correlate with disease activity indicated by the presence of malnutrition and the degree of histological damage of the intestinal mucosa [10].…”

Prolactin and Autoimmunity

“…Recently, a longitudinal study revealed diminished levels of PRL after 6 months following a gluten-free diet. The evidence of decreasing PRL simultaneously with the decline of anti-transglutaminase antibodies suggests a direct connection with a gluten-free diet and hormone levels ( 112 ).…”

Endocrine manifestations in celiac disease

“…For example, prolactin is produced by the anterior pituitary gland, may be important in breast glandular development and may play a role in autoimmune regulatory mechanisms. In some studies, prolactin levels were increased in recently diagnosed CD in pediatric patients and these levels decreased over a few months with a gluten-free diet[ 83 , 84 ].…”